Status:

COMPLETED

The TESLA Trial: Thrombectomy for Emergent Salvage of Large Anterior Circulation Ischemic Stroke

Lead Sponsor:

Mercy Health Ohio

Conditions:

Ischemic Stroke

Eligibility:

All Genders

18-85 years

Phase:

NA

Brief Summary

The primary objective of the trial is to establish the effectiveness of IAT (versus medical management) in patients with moderate-large infarcts (NCCT ASPECTS 2-5) at baseline, with adaptive enrichmen...

Detailed Description

Prospective, randomized, open-label, blinded endpoint study. Patients presenting with symptoms of AIS who have evidence of a moderate-large infarct volume (Non-contrast CT Alberta Stroke Program Early...

Eligibility Criteria

Inclusion

  • 18 to 85 years of age
  • Presenting with symptoms consistent with an acute ischemic stroke
  • Imaging evidence of an anterior circulation occlusion of the Internal Carotid Artery (ICA) terminus and/or Middle Cerebral Artery Main Stem (MCA M1) segment
  • NIHSS score \>6 at the time of randomization
  • Ability to randomize within 24 hours of stroke onset
  • Pre-stroke mRS score 0-1
  • Ability to obtain signed informed consent
  • Imaging evidence of moderate-large infarct defined as:
  • 1\. NCCT ASPECTS 2-5

Exclusion

  • Females who are pregnant, or those of child-bearing potential with positive urine or serum beta Human Chorionic Gonadotropin (HCG) test
  • Known severe allergy (more than a rash) to contrast media uncontrolled by medications
  • Refractory hypertension (defined as persistent systolic blood pressure \>185 mmHg or diastolic blood pressure \>110 mmHg)
  • CT evidence of the following conditions:
  • Midline shift or herniation
  • Evidence of intracranial hemorrhage
  • Mass effect with effacement of the ventricles
  • Computed Tomography Angiography (CTA) evidence suggestive of difficult endovascular access per the treating interventionalist
  • Presence of cervical ICA occlusion (e.g., related to atherosclerotic disease or dissection)
  • Rapidly improving neurological status prior to randomization to NIHSS \<6
  • Bilateral strokes or multiple intracranial occlusions
  • Intracranial tumors
  • Known hemorrhagic diathesis, coagulation factor deficiency, or on anticoagulant therapy with an International Normalized Ratio (INR) of \>3.0 or Partial Thromboplastin Time (PTT) \>3 times of normal
  • Baseline platelet count \<30,000 per microliter (µl)
  • Life expectancy less than 90 days prior to stroke onset
  • Participation in another randomized clinical trial that could confound the evaluation of the study
  • Any other condition (in the opinion of the site investigator) that precludes an endovascular procedure or poses a significant hazard to the patient if an endovascular procedure was performed

Key Trial Info

Start Date :

July 16 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

November 18 2023

Estimated Enrollment :

300 Patients enrolled

Trial Details

Trial ID

NCT03805308

Start Date

July 16 2019

End Date

November 18 2023

Last Update

April 23 2024

Active Locations (43)

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Page 1 of 11 (43 locations)

1

Baptist Health Center for Clinical Research

Little Rock, Arkansas, United States, 72205

2

PIH Health Good Samaritan Hospital and PIH Health Whittier Hospital

Los Angeles, California, United States, 90017

3

Pomona Valley Hospital Medical Center

Pomona, California, United States, 91767

4

Sutter Institute for Medical Research

Sacramento, California, United States, 95816